Abstract

Background Gout therapy includes xanthine oxidase inhibitors (XOI) and colchicine, which have both been associated with decreased cardiovascular
risk. However, their effects on major cardiac events, such as myocardial infarction (MI), need to be investigated further.

Objectives To investigate whether XOIs and colchicine are associated with decreased risk of MI.

Methods This case-control study compared patients with first-ever MI and matched controls. Cases were recruited from the Pharmacoepidemiological
General Research on MI registry. Controls were selected from a referent population (n=8444) from general practice settings.

Results The study sample consisted of 2277 MI patients and 4849 matched controls. Use of allopurinol was reported by 3.1% of cases
and 3.8 of controls, and 1.1% of cases and controls used colchicine. The adjusted OR (95% CI) for MI with allopurinol use
was 0.80 (0.59 to 1.09). When using less stringent matching criteria that allowed for inclusion of 2593 cases and 5185 controls,
the adjusted OR was 0.73 (0.54 to 0.99). Similar results were found on analysis by sex and hypertension status. Colchicine
used was not associated with a decreased risk of MI (aOR=1.17 (0.70 to 1.93)).

Conclusions Allopurinol may be associated with a reduced risk of MI. No decreased risk of MI was found in colchicine users. Besides its
urate-lowering property, allopurinol might have a cardioprotective effect.